Clinical InvestigationInterventional CardiologyA propensity analysis of the risk of vascular complications after cardiac catheterization procedures with the use of vascular closure devices
Section snippets
Methods
We prospectively evaluated consecutive patients undergoing cardiac catheterization and PCIs via femoral access at the Brigham and Women's Hospital between January 1, 2002, and December 31, 2005, for the occurrence of inhospital vascular complications. A prospective catheterization laboratory database, based on the American College of Cardiology–National Cardiovascular Data Registry definitions, was used to record clinical and procedural elements for each case.23 Only patients presenting in
Results
Table I describes the baseline characteristics of the 12 937 study patients, of which 6024 (47%) underwent diagnostic coronary catheterization and 6913 (53%) underwent PCI. Vascular closure devices were used for hemostasis in 9996 cases (77%). Collagen-based Angio-Seal device was used in 8201 (82%), suture-based Perclose device in 1691 (17%), and other VCDs in 104 (1%) cases, respectively. Sixty-seven percent of the patients in diagnostic catheterization and 86% of those in the PCI group
Discussion
The present study describes femoral arterial access site complications and impact of VCDs in >12 000 consecutive patients treated during the contemporary era of diagnostic cardiac catheterization and PCI. The risk of vascular complications was 0.7% in the diagnostic group and 2.7% in PCI patients, which is comparable with previously published literature.1, 5, 6, 7, 8 In this study, the most powerful predictor of complications in both diagnostic and therapeutic groups is nonuse of VCDs. For
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This study was supported, in part, by grants R01-LM08142 (NA and FSR) and 1-T15-LM-07092 (MEM) from the National Library of Medicine of the National Institutes of Health, USA. In addition, the study was supported, in part, by an unrestricted educational grant from St Jude Medical.